Question Title: Outgrowing VUR

In January, 1997, at age 6, my daughter became ill one evening and ended up in the hospital the next morning with a kidney infection. This was her first known infection. Prior to this, she had none of the classic symptoms of a UTI. After her recovery from this infection, a VCUG was performed showing reflux on one side only and no kidney damage at that time. She was put on prophalactic antibiotics and reschuled for a follow up VCUG in one year. She had no breakthrough infections for this period of time. The following year a nuclear VCUG was performed, showing bilateral reflux - grade 3. She was kept on antibiotic and again scheduled for follow up in 1 year. This past January, 1999, at age 8, she once again had nuclear procedure done. This time there was no evidence of reflux on either side. Our doctor discontinued antibiotics and scheduled urine tests every 2 weeks, then 4 weeks and at our last appointment he determined that we no longer needed to see him.

Although I am happy that this seems to have corrected itself, I am also a little skeptical that within 12 months she has gone from bilateral reflus grade 3 to absolutely nothing. I know how sick she was with her first kidney infection and how quickly it came about and I worry that it might happen again.

Do you have any comments on this?

Dear Tarrie,
What you have described in terms of presentation, progression and eventual resolution of your daughter’s urinary reflux is not unusual. It is indeed possible for her to develop an infection again and with it have recurrent reflux. On the other hand, it is also quite likely that she has outgrown the predisposition to get urinary reflux, even in the face of an infection. The only way to know for sure is to stop the antibiotics while everything has been stabalized as in your daughter’s case. If any reinfection occurs, obviously you must restart antibiotics and be seen right away. At that time a new VCUG will be needed to decide about the next step, either continued prophylactic antibiotics, or surgery if any kidney infection/damage is present. However, it is prudent to follow your daughter on a yearly basis with urinalysis and even an ultrasound by your urologist or primary physician, to make sure that she will have no changes. If she has no breakthrough problems for a few years, then she will no longer needs a specific follow-up for her reflux.

This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568).

Sincerely;
HFHS-M.D. BE
* Keyword:vesicoureteral reflux

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